Croakey

Want to see a real food war? This is the stoush to watch

November 6, 2009 – 6:08 pm, by Croakey

In case you missed it, there’s been a minor food spat going on at Crikey. When the nutritionist, Dr Rosemary Stanton, called for foods to be taxed according to their carbon footprint, this, predictably enough, got right up the noses of the Australian Food and Grocery Council, as well as their friends at the Institute of Public Affairs.

But the real food war to watch is underway in the US, and you can read more about it in this investigation, “The Food Lobby’s War on a Soda Tax”, jointly undertaken by the Centre for Public Integrity and the Huffington Post Investigative Fund.

The investigation reports that:

Washington lobbyists have been enjoying a multi-million-dollar sugar rush from the food industry. Soft drink makers, supermarket companies, agriculture and the fast-food business have poured millions into campaigning against what they fear could be a burgeoning national movement to raise money for health care reform by taxing sweetened beverages.

During the first nine months of 2009, the industry groups stepped up their lobbying in Congress. They have spent more than $24 million on the issue of a national excise tax on sweetened beverages and on other legislative and regulatory issues, according to an examination of lobbying reports filed with the Senate Office of Public Records. The review shows that 21 companies and organizations reported that they lobbied specifically on the proposed tax on sugar-sweetened beverages — which among other things would include sodas, juice drinks and chocolate milk.

About $5 million of the money was spent on a national advertising campaign aimed at Capitol Hill lawmakers and promoting a newly formed coalition called Americans Against Food Taxes. The group bills itself on its website as a coalition of “responsible individuals, financially-strapped families, [and] small and large businesses” but its 400-plus membership list is dominated by industry heavyweights such as Burger King Corporation, Coca Cola, PepsiCo and Domino’s Pizza.

The heavyweight lobbying and spending is not so surprising, given what’s at stake for the industry.

In California yesterday, legislators were hearing arguments in favour of a soft drinks tax, including from Professor Kelly Brownell, who was the lead author on this landmark article in the New England Journal of Medicine arguing that there are “compelling” reasons for taxing sugar-sweetened beverages.

According to this LA Times report, one senator told the hearing that he wants “to end the Pepsi Generation,” and compared the marketing of soft drinks to cigarette marketing.

Brownell told the hearing that the landscape for the soda industry is not unlike what it was for the tobacco industry when governments began to increase taxes on cigarettes as a strategy to get people to stop smoking.

Meanwhile, Kellogg has announced that it will withdraw the IMMUNITY claim on Cocoa and other Rice Krispies cereals. The withdrawal follows this report in USA Today, citing concerns held by the San Francisco city attorney and prominent public health experts (including Kelly Brownell).

A collector's item...

A collector's item...

Public health nutritionist Professor Marion Nestle wasn’t impressed by the FDA’s lack of action on the immunity claim, and said the city and state attorneys were doing the FDA’s job.  She also blogged “And let’s hear cheers for the power of the press”.

On related matters, the SMH is  reporting on a project by the International Consortium of Investigative Journalists examining the climate lobby in eight countries including the US, Canada, Australia, India, Japan, China, Belgium and Brazil. The conclusion is that “big greenhouse polluting companies around the world, employing thousands of lobbyists, are exerting heavy pressure on governments to weaken climate change laws at home and slow progress on an international climate agreement in Copenhagen”.

It all starts to sound so familiar doesn’t it….

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Is it time to stop beating up on men?

November 6, 2009 – 10:00 am, by Croakey

The health sector, strangely enough, has a long history of beating up on those it is meant to serve. Men, for example, have been widely castigated for being “poor patients”. What this means is that they haven’t always done what health services or health professionals think they should – ie turn up for appointments, seek help earlier rather than later and so on.

The Federal Government is due to release the country’s first national men’s health policy sometime soon. It’s likely that the policy will try to change some of the rhetoric around men’s health – instead of blaming men for not engaging, the policy may just turn the tables, and ask health services to take a hard look at themselves and what they could do to become more men-friendly.

At least that’s the guess I’m making after reading the information paper that was released earlier this year to support the policy’s development.

“It may be that it is the nature of services that determines willingness to seek help, suggesting the explanation of ‘masculinities’ for lower rates of men’s use of services may not be accurate,” says the paper. “Considerations of availability, access and suitability of services in line with men’s values and practices is likely to offer more fruitful explanations and ways to better engage men with appropriate health service use.”

Men’s health expert, Professor John Macdonald, believes the policy offers a “watershed” moment for men’s health. He writes:

“There will be an Australian National Men’s Health Policy this year, only the second in the world. Unnoticed by many, there has been a national discussion across the country about men’s health needs, initiated by the Department of Health and Ageing.

Instead of academics or medicos saying what men’s health needs are, men themselves were actually asked.

Among other things, the document used to promote this national debate speaks of a social determinants approach to men’s health as well as the need to think of male-friendly health services.

In the first instance, let’s look at the context of men’s lives: the impact of schooling on their health, of work- think of the high rate of industrial accidents in jobs men have to do, or the impact of job insecurity, of social isolation (the population most at risk of suicide in our country is older isolated men), the terrible effects of racism on Aboriginal and Torres Strait Islander men. The call to look at the social determinants of men’s health seems enlightened and compassionate.

The mention of “male-friendly” services marks a watershed.

Men themselves are often seen in our culture to be responsible for their poorer health and blamed for “not going to the doctor”. Whatever truth there may be in this, for once the spotlight can be turned on the doctors and community health services and we can (and I do) ask: “what are you doing to make yourselves “male-friendly”? Not very controversial, one might think. Alas, not so.

Leaving aside the issue of medicine (in this case urology) wanting the top place at the table (of men’s health, and indeed it should have a place), a recent issue of the Health Promotion Journal of Australia shows us that the knives are out to try to ensure the vision of the discussion document gets jettisoned.

Instead, two articles tell us, we should place male violence squarely at the centre of any men’s health policy, and focus on “hegemonic masculinity”.

Australia, Australia! Violence IS a Public health issue. The contradictions of men’s behaviour should not be avoided. Many countries are acknowledging it, both at its worst in sexual abuse but also the physical and psychological manifestations. of course, “No to violence against women!” (Also “No, to violence against children!” the main perpetrators of which are women, incidentally. Check it out!).

But I know of no other country in which academics would rise up in the year of a men’s health policy to demand that violence be central to that policy. S

ome would even say that gender equity as a social determinant is only about the imbalance of power between men and women in society and therefore nothing to do with the inaccessibility of many health services to men.

Gender as a social determinant would be only about this same imbalance and so we don’t have to look at the things already mentioned: health of boys in schools (unless we believe that the enormous amount of Ritalin dispensed to young boys (mainly) is because of their participation in hegemonic masculinity; likewise the many health-damaging male – another manifestation of hegemonic masculinity; socially isolated older men at risk of suicide – their masculinity is the problem, it seems. Aboriginal an Torres Strait Islander men, maybe they die 17 years younger than the rest of us because of the original sin of being “masculine”.

If we want a rational and compassionate men’s health policy, why would we start from the negative?

As a man, I will be castigated for challenging this “received wisdom” So be it.

Thank goodness there are many women who will also be sad if the government is cowed into changing tack and bringing out a men’s health policy focused on non-evidence based sociological constructs to please a certain lobby.

Let’s move away from gender wars and try to work with government to build a balanced, rational, not-afraid-to-look-at-all-contradictions–of-gendered-behaviour health policies for men and women, boys and girls.

• Professor John J Macdonald is Foundation Chair in Primary Health Care and Co-Director, Men’s Health Information and Resource Centre, University of Western Sydney

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Passion DOES have a place in public health

November 4, 2009 – 3:41 pm, by Croakey

The discussion about relationships between public health and the food industry continues…

Boyd Swinburn, Professor of Population Health, and Director of the WHO Collaborating Center for Obesity Prevention at Deakin University, writes:

“Stephen Leeder makes a well argued plea for people to quit blasting the food industry with moral indignation and to work with them to find solutions to the food over-supply and over-promotion which are important drivers of our current obesity epidemic.

Indeed, there are many, many nutritionists, food technologists, dietitians and researchers working with the food industry helping them to re-formulate and market their products.   This is largely positive but that is not the role of everyone.

Public health is politics and effective public health gains have always had as a driving force the combination of passion and science being brought to the political debate. The passion, which I like to think comes from a strong ethical basis rather than a quasi-religious moralistic basis, is an essential ingredient to progress and I would be interested in the rationale or evidence that it is making things worse.

If the passionate advocates, like Rosemary Stanton, had not continually spoken out about the ways that the food industry has been contributing to the obesity problem and has been white-anting the solutions, we would have made very little progress.

It is an unfortunate fact of politics that Rosemary’s approach  will more likely catalyse the ‘banging heads’ meeting of the PM and the industry CEOs that Stephen talks about than will the cooperative approach of the embedded nutritionist or the industry-funded scientist.

But both are important for progress.”

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A bold prediction about Indigenous smoking

November 4, 2009 – 2:16 pm, by Croakey

As the previous Croakey post points out, the news about Indigenous smoking rates may be more encouraging than we’ve previously understood.

Dr Mark Ragg, a health and communications expert, believes the history of smoking among people with mental illness holds some lessons for those working to tackle Indigenous smoking, and also gives cause for optimisim.

He writes:

“David Thomas’ article is fascinating, as well as providing very good news. I’ve come recently to the issue of smoking in Indigenous populations after doing some work in smoking among people with mental illness, and have been struck by the similarities in approaches towards these two disadvantaged groups.

In both cases, there is a false belief that smoking is uniformly high and unchanging, leading to an almost nihilistic belief that nothing is possible. So if nothing is possible, nobody needs to act. And in both cases, smoking is excused by many health workers on grounds like ‘they have nothing better to do’ or ‘I don’t want to jeopardise our relationship by bringing up a difficult issue’.

There are certain things that clearly work to reduce smoking rates in populations – reducing the opportunities to promote smoking, reducing the opportunities for people to smoke, increasing the price and having health professionals give advice, support and medication such as nicotine replacement therapy when needed. Legislation, regulation, social marketing and specific health programs are all means to achieve these ends.

Certainly in people with mental health, and it seems in Indigenous populations, the problem has been that the basics have not been applied. People with mental illness have not had health professionals giving them advice and support. In fact, many people with mental illness are still told to smoke by their doctors.

But some progress is being made. In the US, psychiatrists have specific training programs in smoking cessation which are proving popular and effective, and similar approaches are being considered here.

In Australia, various health services are running smoking cessation programs for people with mental illness, and providing training for employees involved.

Croakey encourages bold predictions, so here’s one.

In 20 years time, policymakers and academics will look at smoking among people with mental illness, and among Indigenous people, and see that these high prevalences were a blip. A troubling time with severe health consequences, but a blip. Once these disadvantaged groups received the same resources and support as others, the problem began to recede.”

• Mark Ragg is director of the health and communications consultancy RaggAhmed and adjunct senior lecturer in the Sydney School of Public Health, University of Sydney.

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And now for some good news on Indigenous health

November 4, 2009 – 2:07 pm, by Croakey

We are so inundated by bad news about Indigenous health that it’s easy to be overwhelmed by doom and gloom. But when it comes to smoking – a major cause of sickness and premature death – the news may be more encouraging than we’ve previously thought.

Dr David Thomas, a senior research fellow at the Menzies School of Health Research in Darwin, reports:

“In March last year, the National Indigenous Health Equality Summit set a target of reducing Indigenous smoking prevalence by 2% every year.  It sounds great: so much Indigenous suffering would be avoided and so many early deaths averted.

Tobacco control became a big ticket item in Rudd and Roxon’s plans to ‘Close the Gap’, with millions committed in last March’s Indigenous Tobacco Control Initiative and millions more to come as part of their COAG initiatives.  But few would have really believed that the 2% target could be achieved: just aspirational slush like ‘no child will live in poverty’.

Back then, the hard truth was that Indigenous smoking prevalence had not changed whilst smoking was successfully falling in the rest of the population.  This was based largely on three large national Indigenous surveys performed by the Australian Bureau of Statistics in 1994, 2002, and 2004.  All other national survey data had tiny Indigenous samples, and so provided useless estimates.  Each of the ABS surveys reported that about 50% of Indigenous adults smoked, about double the Australian prevalence of smoking.

What most readers have overlooked is that the reports of these surveys used different age cut-offs and different definitions of smoking (daily or all current smokers).  This week in the International Journal for Equity in Health, I described the prevalence of current smoking amongst Indigenous adults aged 18 and over in each survey.

From 1994 to 2004 Indigenous smoking prevalence in non-remote Australia fell in parallel with the total Australian population (by 5.5% in men and 1.9% in women).  In remote Australia, smoking prevalence also fell amongst men (by 3.5%) and appears to have peaked in women.  These two different trends can be neatly explained by international research about the shape of smoking epidemics, with remote Indigenous Australia just at an earlier point in the predictable smoking epidemic curve than Indigenous peoples in non-remote Australia.

Also this week, the ABS released the first results of the fourth national Indigenous survey in this series.  Detailed comparisons are not yet possible, but they too have reported a drop in national Indigenous smoking, from 51% in 2002 to 47% in 2008.

Even though both of this week’s reports have some limitations, we can reasonably confidently say that Indigenous smoking prevalence is not resiliently static, as once thought.  The Indigenous smoking epidemic is not exceptional, and there is no need to entirely re-think and re-fashion tobacco control in this setting.  We can adapt what has been successful in Australia and elsewhere.

Reducing Indigenous smoking is no longer a seemingly impossible task.

Indigenous smoking was slowly falling before a cent of the new money was spent.  How fast it falls now the new money is starting to hit the ground will depend on how that money is spent.

We should feel emboldened by this week’s news.  We should no longer call ‘encouraging’ any future reduction in Indigenous smoking; we should expect a dramatic reduction, maybe even the fabled 2% annual reduction dreamed up last March.”

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Opening another front in the public health/food industry debate

November 4, 2009 – 1:41 pm, by Croakey

The recent debate between nutritionist Dr Rosmary Stanton and PepsiCo executive Dr Derek Yach generated much discussion at Croakey. Many public health experts were sceptical about the intentions of companies like PepsiCo.

However, Stephen Leeder, Professor of Public Health at the University of Sydney, argues that the public health community needs to move beyond moral indignation to effective engagement with industry.

He writes:

“The recent Croakey conversation about obesity and the soft drink industry is imbued with strong moral concerns, as is the public health community more generally – many members march at the front of the platoon that seeks to secure equitable access to health care, even, indeed, equal health outcomes from care or equality of health status.

No great problem there: this moral concern has motivated deep inquiry into the social determinants of health and action to tackle maternal and child survival, extreme poverty, the humane care of people with AIDS and Indigenous health.  It is in sympathy with international movements that promote human rights generally and those pertaining to health specifically.

While this moral concern has generated power in the grid of modern public health action – including the battles fought and partially won with tobacco companies – paradoxically it may inhibit progress in achieving better health for people who suffer because of the negative effects of global economic expansion, city building and food manufacture.  Illnesses caused by these changes now dominate the lists of global mortality and morbidity.

Why may our moral indignation in public health be a problem?  Before answering that question we need to hear a word from the philosopher John Rawls.

As Denver ethicist Jack Donnelly wrote recently in a monograph on concepts of human dignity, Rawls distinguishes notions of justice that derive from religious and philosophical doctrines such as Islam and Marxism from “political conceptions of justice”.

These, in Donnelly’s words, “address the political structure of society, defined (as far as possible) independent of any particular comprehensive doctrine. Adherents of different comprehensive doctrines may be able to reach an overlapping consensus on a political conception of justice.”

What Donnelly is getting is that while the foundational motivations and ideology of different people will vary, and sometimes radically so, it remains possible “to achieve an overlapping consensus [that is] partial rather than complete.  It is political rather than moral or religious.”

Many of the solutions to our current health woes undoubtedly sit outside the health sector, and will involve stakeholders with sometimes very different values and objectives and different concepts of morality.  Finding the points of ‘overlapping consensus’ is key for us to move forward towards  health gain.

Recently in Sydney we listened to two points of view – from Derek Yach and Rosemary Stanton – about nutrition and how it might be altered in favour of a slimmer society.  Derek works with PepsiCo and Rosemary definitely does not!  Both are people of impeccable public health credentials and they deliberated about how we might enter an age where obesity and its dark consequences did not dominate our thinking.

It has generated lively debate but I do not see how we can make progress until such time as we accept that a solution to this problem will be based on a political conception of social justice, to use Donnelly’s term – at the school, local government, state and federal levels.  It will be a political and pragmatic rather than ideological notion of justice that will motivate action.

Instead of allowing ourselves the indulgence of shouting from the moral high ground about the motivations of industry, perhaps we should seek a consensus around what a social conception of justice in regard to food means.

We need as public health people to get over our shock and horror at food companies being primarily motivated by profit.  We need to move beyond saying, “Their good will is just PR!”  A mutual understanding of each other’s values and goals is essential to merit a seat at the table, a table of policy and politics.

This applies to many public health policy problems.  Recognising a problem, and even understanding it is different to choosing the most effective course of action, knowing how to speak in terms that industry will take seriously, being pragmatic and knowing how to go about getting things done when success more often than not requires people to negotiate the politics.

This viewpoint is reinforced by my previous experience.  Two years ago I participated in a Canberra meeting hosted by Senator Guy Barnett about obesity.  I chaired a small working group that included representatives from the food industry, academic nutrition, advertising, media and urban designers.  Naturally we sparred about traffic light food labeling, advertising on children’s TV and other contentious topics, but we all stayed till the going home bell sounded.  The conversation was prickly but OK.

Just before we went, one of the participants turned to me and said, “You know, professor, you have the wrong people at this forum.  We’re middle managers. You need the CEOs. If they say something is going to change, it will.”

I was pondering the good sense of this suggestion – and others were nodding affirmatively, when my colleague added, “And you’re the wrong person to be chairing it.  We should have the PM and a few of his ministers without their bureaucrats at the table.  He could say to them all, ‘We have a problem and we are all going to contribute to its solution, so before you leave today I want to hear what you are going to do to help!’”

Besides revising our attachment to moral indignation, the other thing we need is a clear view of how long it has taken us to get into a situation where nearly half of all Australian adults and close to three in every 10 Australian children are overweight or obese, a mess that has disturbing similarities to global warming.  Decades: so it will probably take decades to get out.

The history of public health progress is nearly always of incremental change with many people taking many different actions.  Even the apocryphal wrenching removal of the Broad Street water pump handle has a richer context than we commonly recognize.

That is why public health is accurately perceived as a community movement and public health research workers as social scientists.  There are times when aggressive advocacy and the force of the law are necessary.  At other times they are not.  Then, as Churchill put it, we need jaw-jaw and not war-war.

The rise and rise of obesity is complex.  Recruiting the food industry – or a bit of it anyway – to our cause, while being true in our policy discussions with them to a “political conception of justice,” strikes me as a good move.

I am not at all convinced that confrontation and moral indignation do anything in this context other than make things worse.   This does not mean that we should be silent if we find abuse and hypocrisy but rather in conversation we should define those interests that are common and where, if a consensus is struck – by the PM if not by us – we can inch forward.”

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Where are the Feds in the Central Australian dialysis dilemma?

November 4, 2009 – 9:32 am, by Croakey

As the previous Croakey posts report, the NT Government is under fire for its policy of refusing dialysis treatment in Alice Springs to Central Australians who live outside the Territory’s borders.

But the spotlight should be put on the Federal Government, argues Professor Wendy Hoy, of the Centre for Chronic Disease, School of Medicine, University of Queensland.

She writes:

“This problem of provision of dialysis services across state/territory booundaries would be solved if the Federal Government assumed responsibility for all such services across Australia.

If the federal government also takes charge of primary care services, at least where current options are not satisfactory, the links between death rates and need for dialysis with efforts in prevention, timely screening and quality treatment of chronic diseases in their asymptomatic and their less advanced stages would become clear.

This would allow informed health services planning to minimise sickness, dialysis, premature death and costs.

The Federal government could contract back with local providers for those services, where current systems are effective, transparent and accountable, but everything would come under one umbrella and one system of ongoing evaluation of processes, outcomes and costs. Inclusion of hospital services under such an umbrella is an obvious option.”

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NT Govt urged to stop turning away sick patients

November 3, 2009 – 6:47 pm, by Croakey

Continuing the thread from the previous post, the Aboriginal Medical Services Alliance Northern Territory is warning that the NT Government’s policy of refusing dialysis treatment for patients from outside the Territory is causing enormous harm.

This is the statement:

AMSANT has written to the Northern Territory Health Minister with a potential solution to needless deaths among central Australian renal dialysis patients, AMSANT Chairperson Stephanie Bell said today.

“The current policy of refusing to treat Aboriginal patients in Alice Springs is contributing to early deaths for Aboriginal people,” Ms Bell said.

“Sending people from remote communities to Perth or Adelaide is creating enormous psycho-social impacts on individuals, their families and their communities.

“Some people are opting to refuse or withdraw from treatment so they can go back to their country to die: it is an intolerable situation.

“The patients concerned live on or close to their ancestral estates—and didn’t “ask” for those estates to be alienated from their kin and country by the arbitrary imposition of state and territory border lines.

“We have suggested to Minister Vatskalis that a short term solution is available—nocturnal dialysis—and that AMSANT would back the Territory Government in seeking proper recompense from the South and Western Australian governments, as well as Commonwealth support.

“The demand that they move many thousands of kilometres to distant capital cities is irrational and—in the long term—far more expensive than treatment closer to home in a regional centre such as Alice Springs.

“The tri-state committee dealing with these issues for 18 months and has done little more than sit on its hands.”

Ms Bell said that AMSANT realises that the Northern Territory is in an invidious position in being asked to take on patients that don’t “belong” to the Territory in a jurisdictional sense. She said the costs of introducing night dialysis at the Alice Springs Hospital, along with social and housing support, should be met by interstate governments.

“This is clearly a short to medium term solution, one that will be relieved to an extent with the new satellite facility opening in April next year,” said Ms Bell.

“Beyond that, of course, we must work towards peritoneal and haemodialysis being made available in the regions to reduce the load on facilities in Alice Springs.”

Croakey suspects that this is just one slice of a much bigger story about how Indigenous patients with kidney disease miss out on all sorts of potentially life-saving interventions – including measures that might help prevent the need for dialysis in the first place.

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A plea for support for Aboriginal patients in Central Australia

November 3, 2009 – 4:36 pm, by Croakey

Below is an extract of an open letter that is being circulated to raise awareness of the plight of Aboriginal people in central Australia who are no longer able to access dialysis services in Alice Springs.

It is from Sarah Brown, Manager of the Western Desert Nganampa Walytja Palyantjaku Tjutaku, an organisation that provides support to Aboriginal people needing dialysis (more details on the organisation at the bottom of the letter).

She is urging people to write to the relevant Ministers in the WA, NT and Federal Governments. She writes:

Dear friends

Thank you for your interest in the plight of renal patients in the most remote parts of Central Australia.  People from communities in the desert regions outside the NT border are no longer able to access dialysis services in Alice Springs. This has and will have a devastating effect on individuals, families and communities who have always looked to Alice Springs for their health care and support services.

The situation of Patrick Tjungurrayi who contributed significantly to the setting up of our community controlled dialysis and support services has helped us to highlight this issue.

The NT Government says they require the WA and SA governments to make a substantial contribution to service provision in Alice before dialysis can be offered to people from over the borders. They say that these negotiations may take a long time. But while governments cost shift and pass the buck, people are getting sick with little hope of receiving treatment close to home.

We need your help to let governments know that these people are not forgotten and this situation imposed upon them by the enforcement of arbitrary state boundaries is CAUSING GREAT HARDSHIP.

We ask you to consider sending letters and or emails voicing your concerns to any or all of the following politicians/bureaucrats listed below.

It would help us if you sent a copy of anything you do to this email too. This will help us to follow up with politicians and to keep you posted on developments.

Any suggestions, ideas, comments or lateral thinking about solutions to the problem would be gratefully received!

Thanks so much for your help and interest!

Sarah Brown
Manager
Western Desert Nganampa Walytja Palyantjaku Tjutaku

Sarah has provided the following additional background for Croakey readers:

The Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation (WDNWPT) began ten years ago as the Western Desert Dialysis Appeal.

Pintupi people from Kintore and Kiwirrikurra with the help of Sothebys and Papunya Tula Artists painted large collaborative works and held an auction at the Art Gallery of New South Wales. A million dollars was raised to improve life for people from the Western Desert forced to relocate to Alice Springs for dialysis treatment for End Stage Renal Failure.

All indigenous people in the Western Desert are eligible to be members of the organisation. As a model of good governance, WDNWPT has twelve elected directors from across the region. They are community leaders and respected community members. Our chairperson is Marlene Spencer, Senior Health Worker at Pintupi Homelands Health Service. Meetings are held regularly and Directors, patients and family members take an active part in running the organisation.

For five years WDNWPT has had a nurse and a dialysis machine in Kintore. This has enabled people to return home to country and family. WDNWPT also has a house in Alice Springs (The Purple House), with two machines enabling us to teach self care dialysis and provide a range of social and cultural activities aimed at improving quality of life and contributing to the Alice Springs community.

Our committee is proud of what it has achieved thus far but devastated that they are no longer able to offer the services of the organisation to people from across the border in WA who are their family because of the NT government’s ban on dialysis patients from WA coming to Alice.

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Two books that you shouldn’t miss

November 3, 2009 – 12:05 pm, by Croakey

Professor Kerry Goulston, Emeritus Professor of Medicine at the University of Sydney, has sent in the following review of two books likely to interest Croakey readers.

He writes:

“There are two outstanding books which I can highly recommend.

First, “Direct Red” by Gabriel Weston, who is a young Scottish Surgeon and a gifted narrator.  She describes openly her travails as a young doctor and why she put her family first.  It is beautifully written.

Secondly,  “Vital Signs” by Ken Hillman. Ken is Chief Intensivist at Liverpool Hospital in Sydney. Probably best known for his pioneering of Medical Emergency Teams. He has put together reflective vignettes from his own experience. Again extremely well written and provocative.

Both these books epitomise the Art of Medicine – caring for and with the patient. In these bureacratic days, we need this reminder.  Too often we lose sight of what Medicine is really about.

Both authors tell us through their own experiences and with great writing skills that the patient is what it is about -  not length of stay, not efficiency, not budget – but about interaction between doctor and patient.

We can all do better.  We can and should reflect on that. Not for the sake of Quality and Safety but because we want to serve our individual patients better.

These books are well crafted  and they remind us what it is all about – the need to look after ourselves as as well as  our patients.

Lord Darzi in the UK realised this. We need similar leading clinicians here to do likewise.

Let the Government, let the bureaucrats know – it is about the  Patient-Doctor relationship. That is what is important – send them these books too!!

If you know  a medical student or young doctor, it’s worth buying both for them—but read them first yourself.”

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